Impacted Central Incisors in the Upper Jaw in an Adolescent Patient: Orthodontic-Surgical Treatment—A Case Report

Abstract

The inclusion of both maxillary permanent central incisors is uncommon. This condition compromises face aesthetics, phonation and masticatory function. Therefore, early diagnosis is essential to avoid complications and failures. There are various reasons for inclusion, but supernumerary teeth are the leading cause. Early causes of removal and rapid expansion of the palate determine a high probability of success with the spontaneous eruption of the impacted elements. However, it is often necessary to proceed with a surgical–orthodontic treatment. The inclination of teeth in relation to the midline and the root maturation degree determine prognosis and therapeutic timing. In this case report, the orthopantomogram (OPG) X-ray of a 9-year-old boy revealed two impacted supernumerary teeth in the anterior maxillary region, preventing the eruption of the permanent upper central incisors. The impacted supernumerary teeth were surgically removed at different times. A straight wire multibrackets technique associated with a fixed palatal appliance was used. The palatal appliance featured an osteomucous resin support at the level of the retroincisal papilla. Subsequently, surgical exposure was carried out using the closed eruption technique and elastic traction, bringing 11 and 21 back into the arch.

Deep Bite Treatment with Aligners: A New Protocol

“…According to a recent review of the literature conducted by Papadimitriou on the efficacy of Invisalign therapy on different types of malocclusions, Invisalign was found to be effective for tipping and rotation movements. Moreover, the results of Invisalign therapies may be comparable with those of fixed multibracket therapies in the case of little or medium crowdings in adult patients who do not require extractions [33,34].…”

Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report

“…MARPE expansion is a valid alternative to the therapy of transverse discrepancies in the adolescent patient and allows excellent results to be achieved about orthopedic results, with fewer undesirable effects than traditional expansion, and also extends the possibilities of treatment in adult patients [ 32 , 49 , 50 ].…”

“…Vestibular bone resorption at the level of the maxillary molars is lower in patients who undergo treatment with hybrid devices. Although bone ridge thickness at the palatal level increases regardless of device type, at the vestibular level vertical and horizontal bone resorption is lower in MARPE patients; this correlates with a lower risk of bone dehiscence [ 37 , 50 ].…”

“…Mostly of the expander appliances reported in literature are hybrid, characterized by both dental and bone support through miniscrew anchorage [37]. MARPE expansion is a valid alternative to the therapy of transverse discrepancies in the adolescent patient and allows excellent results to be achieved about orthopedic results, with fewer undesirable effects than traditional expansion, and also extends the possibilities of treatment in adult patients [32,49,50].…”

Treatment of Class III Malocclusion and Anterior Crossbite with Aligners: A Case Report

“…The patient preferred to wear orthodontic aligners instead of fixed multibracket appliances. Aligners can be more aesthetic than fixed orthodontics and allow patients to clean their teeth more easily [ 36 , 62 ]. Like a fixed appliance, aligners allowed the application of class III elastics to reinforce lower anterior anchorage during lower first and second molars distalization after the extraction of the lower third molars.…”